A new formula to define value, as presented in the paper, equates “real value” with appropriateness – already a widely used cost-effectiveness tool – together with clinically defined outcomes and patient-expected outcomes relative to costs.
“Physicians are ready for new tools and strategies to improve patient care, and interventional cardiologists’ long-standing commitment to innovation and quality improvement have enabled us to propose a solution and kick-start its adoption,” said Peter L. Duffy, MD, MMM, FSCAI, medical director of the cardiovascular service line at the Reid Heart Center/FirstHealth of the Carolinas, Pinehurst, NC, and the paper’s author.
The Real Value Equation captures the Institute of Medicine’s (IOM) six dimensions of quality – care that is safe, effective, efficient, timely, patient-centered and equitable – while emphasizing how its application in everyday practice will help physicians provide better care by allowing them to customize care for the individual patient’s needs while also adhering to best practices, guidelines and appropriate use criteria (AUC). The lens through which interventional cardiologists can view decisions is based on the following four parameters:
- The extent to which the benefit of the procedure outweighs the risk
- The expected effect on the patient’s quality of life
- How much the procedure reduces long- and short-term risk of complications
- Whether the procedure will extend the patient’s life expectancy with the level of quality of life they expect
While current efforts such as AUC have been effective at guiding treatment decisions, focusing on AUC alone will not result in better population-based outcomes and will not address long-standing concerns regarding patient-centered care and spiraling healthcare costs, according to the author. He calls for interventional cardiologists to continue their legacy as leaders in innovation and quality improvement by integrating appropriateness with clinical outcomes, patient expectations and resource utilization into clinical practice.
“With heart disease care accounting for more than 40 percent of every healthcare dollar spent in the United States[i], interventional cardiologists are at the forefront of the conversation about how to change health care. We have the ability to make changes in our practice that will lead the way to meaningful change in this new phase of healthcare reform,” said Dr. Duffy. “As the Real Value equation takes hold, the possibilities to apply it beyond cardiology to every field will only become clearer, which is truly exciting.”
The paper, titled “Real Value: A Strategy for Interventional Cardiologists to Lead Healthcare Reform,” is e-published in Catheterization and Cardiovascular Interventions. Download it now.
The Society for Cardiovascular Angiography and Interventions is a 4,000-member professional organization representing invasive and interventional cardiologists in approximately 70 nations. SCAI’s mission is to promote excellence in invasive/interventional cardiovascular medicine through physician education and representation, and advancement of quality standards to enhance patient care. SCAI’s public education program, Seconds Count, offers comprehensive information about cardiovascular disease. For more information about SCAI and Seconds Count, visit www.SCAI.org or www.SecondsCount.org. Follow @SCAI and @SCAINews on Twitter for the latest heart health news.
[i] Lloyd-Jones, D. AHA Statistical Update Heart Disease and Stroke Statistics. Circ 2010; 121;e46-215.